SB 188 — Residential Treatment for Members in Colorado Department of Human Services Custody

SecondSENATE RegularBILL Session26-188 Seventy-fifthBY GeneralSENATOR(S) AssemblyAmabile STATEand OFKirkmeyer, COLORADOBridges, REREVISEDExum, ThisSimpson, VersionColeman; Includes All Amendments Adopted in the Second House LLS NO.

26-0929.01also ShelbyREPRESENTATIVE(S) RossBrown x4510 SENATE BILL 26-188 SENATE SPONSORSHIP Amabile and Kirkmeyer,Taggart, Bridges,Sirota, Coleman,Boesenecker, Exum,Clifford, SimpsonDuran, HOUSEGilchrist, SPONSORSHIPLindsay, BrownandTaggart, Sirota,Boesenecker,Clifford,Duran,Gilchrist,Lindsay,McCluskie, McCormick, Ricks, Rydin, SmithSmith, dMcCluskie. d e 6 E a 0 S U , U g 1 H d y e M Senate Committees House Committees R Appropriations Appropriations 3 A BILL FOR AN ACT e n 6 C ONCERNING THE TRANSITION OF RESIDENTIAL TREATMENT E m 0 S n , PROGRAMS TO THE STATEWIDE MANAGED CARE SYSTEM FOR O U 1 H i a a M MEDICAID MEMBERS WHO ARE IN THE CUSTODY OF A COUNTY R d DEPARTMENT OF HUMAN OR SOCIAL SERVICES .

2C BillONCERNING SummaryTHE dTRANSITION dOF eRESIDENTIAL 6TREATMENT (Note:PROGRAMS TO THE STATEWIDE MANAGED CARE SYSTEM FOR MEDICAID MEMBERS WHOAREINTHECUSTODYOFACOUNTYDEPARTMENTOFHUMANOR SOCIAL SERVICES .

This summary applies to this bill as introduced and does E a 2 T U 2 notreflectanyamendmentsthatmaybesubsequentlyadopted.Ifthisbill N g 7 passes third reading in the house of introduction, a bill summary that S d a e M applies to the reengrossed version of this bill will be available at R http://leg.colorado.gov/.) 3 Joint Budget Committee.

No later than July 1, 2026, the department of health care policy and financing (HCPF) shall convene a e n steering committee (steering committee) to support the transition of m 2 T n 0 A U , E i y Shading denotes HOUSE amendment.

Double underlining denotes SENATE amendment.

S a a Capital letters or bold & italic numbers indicate new material to be added to existing law.R M Dashes through the words or numbers indicate deletions from existing law.

n servicesprovidedinqualifiedresidentialtreatmentprograms(QRTP)and psychiatric residential treatment facilities (PRTF) to the managed care system for members in the care and custody of a county department of human or social services (county department).

No later than April 1, 2027, HCPF, in collaboration with the steering committee, shall develop policies and recommendations to supportthetransitionofQRTPandPRTFtothemanagedcaresystemfor members in the care and custody of a county department.

No later than July 1, 2027, HCPF shall implement or initiate the transition of services provided in QRTP and PRTF to the managed care system for members in the care and custody of a county department according to the policies and recommendations developed by HCPF in collaboration with the steering committee.

HCPFshallsubmitquarterlyreportstothejointbudgetcommittee with information about the steering committee's monthly meetings.

(1) (a) NON O LATER THAN ULYJULY 1, 2026THE2026, STATE DEPARTMENT SHALLCONVENEASTEERINGCOMMITTEETOSUPPORTTHETRANSITIONOF SERVICES PROVIDED IN QUALIFIED RESIDENTIAL TREATMENT PROGRAMS ANDPSYCHIATRICRESIDENTIALTREATMENTFACILITIESTOTHEMANAGED CARE SYSTEM FOR MEMBERS IN THE CARE AND CUSTODY OF A COUNTY DEPARTMENTOFHUMANORSOCIALSERVICES .THESTEERINGCOMMITTEE MAY CONSULT WITH OTHER STATE DEPARTMENTSDEPARTMENT AND________ AGENCIESCapital ,letters INCLUDINGor THEbold DEPARTMENT& OFitalic EARLYnumbers CHILDHOODindicate ,ANDnew RELEVANTmaterial STAKEHOLDERSadded ASto NECESSARYexisting TOlaw; FULFILL ITS DUTIES .

HEdashes STEERINGthrough COMMITTEEwords MUSTor INCLUDEnumbers LEADERSHIPindicate REPRESENTATIONdeletions FROMfrom :existing law and such material is not part of the act.

-2-SHALL 188CONVENE (I)A STEERING COMMITTEE TO SUPPORT THE DEPARTMENTTRANSITION OF HEALTHSERVICESPROVIDEDINQUALIFIEDRESIDENTIALTREATMENTPROGRAMSAND PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES TO THE MANAGED CARE POLICYSYSTEM FOR MEMBERS IN THE CARE AND FINANCING;CUSTODY OF A COUNTY DEPARTMENT OF HUMAN OR SOCIAL SERVICES .

HE STEERING COMMITTEE MAYCONSULTWITHOTHERSTATEDEPARTMENTSANDAGENCIES ,INCLUDING THEDEPARTMENTOFEARLYCHILDHOOD ,ANDRELEVANTSTAKEHOLDERSAS NECESSARY TO FULFILL ITS DUTIES .

THE STEERING COMMITTEE MUST INCLUDE LEADERSHIP REPRESENTATION FROM :

(I) THE DEPARTMENT OF HEALTH CARE POLICY AND FINANCING ;

(III) THET HE BEHAVIORAL HEALTH ADMINISTRATION IN THE DEPARTMENT OF HUMAN SERVICES ;

(V) QQUALIFIEDRESIDENTIALTREATMENTPROGRAMPROVIDERSAND UALIFIED RESIDENTIAL TREATMENT PROGRAM PROVIDERS AND PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY PROVIDERSPROVIDERS,INCLUDING , INCLUDING A STATEWIDE ASSOCIATION REPRESENTING PROVIDERS;ANDPROVIDERS ;AND (VI) M ANAGED CARE ENTITIES.

(b) BEGINNINGBEGINNINGJULY JULY1,2026,THESTEERINGCOMMITTEESHALLMEET 1, 2026,THE STEERING COMMITTEE SHALL MEET AT LEAST ONCE PER MONTH UNTIL ULYJULY 1, 2027.

(c) THE STEERING COMMITTEE SHALL IDENTIFY,EVALUATEIDENTIFY ,EVALUATE ,AND DEVELOP RECOMMENDATIONS ON POLICY AND OPERATIONAL ISSUES RELATED TO THE TRANSITION DESCRIBED IN SUBSECTION (1)(aOF THIS SECTION AND ENSURE THAT UPDATES ,POTENTIAL DECISION POINT,ANDPOINTS,AND DECISIONS MADE BY THE STATE DEPARTMENT ARE COMMUNICATEDCOMMUNICATEDTO TO AND VETTED WITH THE LEADERSHIP OF EACH MEMBER S RESPECTIVE ORGANIZATION OR CONSTITUENCY .

(2) NON O LATER THAN AAPRIL1, PRIL1,2027,THE 2027THE STATE DEPARTMENT ,IN COLLABORATIONCOLLABORATIONWITHTHESTEERINGCOMMITTEE WITH,SHALLDEVELOPPOLICIES THE STEERING COMMITTEE , SHALL DEVELOP POLICIES AND RECOMMENDATIONS ININLINE LINEWITHFEDERALFINANCIALPARTICIPATION WITH FEDERAL FINANCIAL PARTICIPATION AND MANAGED CARE REGULATIONS AND REQUIREMENTS TO SUPPORT THE PAGE 2-SENATE BILL 26-188 TRANSITION OF QUALIFIED RESIDENTIAL TREATMENT PROGRAMSANDPSYCHIATRICRESIDENTIALTREATMENTFACILITIESTOTHEPROGRAMS AND PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES TO THE MANAGED CARE SYSTEM FOR MEMBERS IN THE CARE AND CUSTODY OF A COUNTYDEPARTMENTOFHUMANORSOCIALSERVICESCOUNTY .TDEPARTMENT HEPOLICIESANDOF RECOMMENDATIONSHUMAN MUSTOR INCLUDESOCIAL ,BUTSERVICES ARE. NOT LIMITED T:

-3-THE 188POLICIES (a) CLEARLY DEFINED ROLES, RESPONSIBILITIE, AND DECISION-MAKINGRECOMMENDATIONS AUTHORITYMUST ACROSSINCLUDE MANAGED,BUT CAREARE ENTITIESNOT ,LIMITED COUNTIEST: , PROVIDERS , AND STATE AGENCIES , INCLUDING ACCOUNTABILITYFORMEDICALNECESSITYDETERMINATIONS ,PLACEMENT DECISIONS,DISCHARGE PLANNING,CARE COORDINATION ,AND PAYMENT ;

(b)(a) SC TATEWIDELEARLY STANDARDSDEFINED FORROLES UTILIZATION MANAGEMENT , INCLUDINGRESPONSIBILITIE, AUTHORIZATIONAND ,CONTINUEDDECISION-MAKINGAUTHORITYACROSSMANAGEDCAREENTITIES STAY,COUNTIES, REVIEW,ANDPROVIDERS DISCHARGE,AND PLANNINGSTATE ,WITHAGENCIES CLARITY, ONINCLUDING THEACCOUNTABILITY APPLICATIONFOR OFMEDICALNECESSITYDETERMINATIONS MEDICALPLACEMENTDECISIONS NECESSITY,DISCHARGE DETERMINATIONSPLANNING AND,CARE CONSIDERATIONCOORDINATION OF,AND THEPAYMENT UNIQUE CLINICAL AND PLACEMENT -RELATED NEEDS OFCHILDREN AND YOUTHINVOLVEDIN THE CHILD WELFARE SYSTEM ;

(c)(b) REQUIREMENTSSTATEWIDE STANDARDS FOR TIMELYUTILIZATION ENGAGEMENTMANAGEMENT AUTHORIZATION , ANDINCLUDING CAREAUTHORIZATION COORDINATION, ACROSSCONTINUED ENTITIESSTAY ,INCLUDINGREVIEW DEFINED,AND TIMEDISCHARGE FRAMESPLANNING AND,WITH EXPECTATIONSCLARITY FORON REALTHE TIMEAPPLICATION COORDINATIONOF FORMEDICAL YOUTHNECESSITY INDETERMINATIONS CRISISAND ORCONSIDERATION AT RISK OF PLACEMENTTHE DISRUPT;ONUNIQUE (d)CLINICAL TRAINING AND TECHNICALPLACEMENT ASSISTANCE-RELATED NEEDS FOROF MANAGEDCHILDREN CARE ENTITIES, COUNTIES,AND QUALIFIED RESIDENTIAL TREATMENT PROGRAM AND PSYCHIATRICYOUTH RESIDENTIALINVOLVED TREATMENTIN FACILITY PROVIDERS RELATED TO THE CONSISTENTCHILD APPLICATIONWELFARE OFSYSTEM MEDICAL; NECESSITY CRITERIA,INCLUDING DOCUMENTATION EXPECTATIONS AND AUTHORIZATION PROCESSES AND TIMELINES FOR EACH;

(e)(c) CARERQUIREMENTSFORTIMELYENGAGEMENT COORDINATIONEXPECTATIONSACROSSMANAGEDCAREAUTHORIZATION ENTITIESCOUNTIES,AND ,ANDQUALIFIEDRESIDENTIALTREATMENTPROGRAM AND PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY PROVIDERS TO IMPROVE COMMUNICATION , REDUCE DUPLICATION , AND SUPPORT CONTINUITY OF CARE,INCLUDING HOW FAMILIES ARE INTEGRATED INTO THE TREATMENT PROCESS AND PROCESSES TO ADDRESS CARE -4-COORDINATION 188ACROSS COORDINATIONANDACCESSTOSERVICESFORYOUTHINDETENTIONENTITIES,INCLUDING WITHDEFINED CLARITYONTIME ELIGIBILIT,ASSIGNMENTFRAMES TOANDEXPECTATIONSFORREAL MANAGEDCARE-TIMECOORDINATIONFORYOUTHINCRISISOR ENTITIESAT ,ANDRISK ROLES AND RESPONSIBILITIES FOR COVERAGE , AUTHORIZATION ,AND COORDINATION OF BEHAVIORALPLACEMENT HEALTHDISRUPTION; SERVICES DURING AND FOLLOWING PERIODS OF DETAINMENT ;

(f)(d) DISCHARGETRAINING PLANNING REQUIREMENTS AND AFTERTECHNICAL CAREASSISTANCE SUPPORTNEEDS FOR ATMANAGED LEASTCARE SIXENTITIES, MONTHSCOUNTIES AFTER,AND DISCHARGEQUALIFIED ,RESIDENTIAL INCLUDINGTREATMENT EXPECTATIONSPROGRAMANDPSYCHIATRICRESIDENTIALTREATMENTFACILITYPROVIDERS THATRELATED DISCHARGETO PLANNINGTHE BEGINSCONSISTENT ATAPPLICATION ADMISSIONOF ANDMEDICAL THATNECESSITY ALLCRITERIAINCLUDINGDOCUMENTATIONEXPECTATIONSANDAUTHORIZATION RELEVANTPROCESSES PARTIESAND HAVETIMELINES AFOR SHAREDEACH; UNDERSTANDING OF THE DISCHARGEPLANANDOFAVAILABLESTEP -DOWNANDCOMMUNITY BASED SERVICE OPTIONS;

(g)(e) RECOMMENDATIONSTOADDRESSSYSTEMBARRIERSRELATEDCARE TODISCHARGEPLANNINGCOORDINATION ,PLACEMENTAVAILABILITYEXPECTATIONS ANDCONTINUITYOFACROSS MANAGED CARE ENTITIES,COUNTIES,AND QUALIFIED RESIDENTIAL TREATMENT PROGRAM AND PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY PROVIDERS TO IMPROVE COMMUNICATION , INCLUDINGREDUCE ALIGNMENTDUPLICATION BETWEEN, CLINICALAND READINESSSUPPORT CONTINUITYOFCARE ,INCLUDINGHOWFAMILIESAREINTEGRATEDINTOTHE TREATMENT PROCESS AND PROCESSES TO ADDRESS CARE COORDINATION AND ACCESS TO SERVICES FOR DISCHARGEANDAVAILABLEPLACEMENTORCOMMUNITYYOUTH -BASEDSERVICEIN OPTIONS;DETENTION ,WITH CLARITY ON ELIGIBILITYASSIGNMENT TO MANAGED CARE ENTITIES ,AND ROLES AND RESPONSIBILITIESFORCOVERAGE ,AUTHORIZATION ,ANDCOORDINATIONOF PAGE 3-SENATE BILL 26-188 BEHAVIORAL HEALTH SERVICES DURING AND FOLLOWING PERIODS OF DETAINMENT ;

(h)(f) PROCESSESDSCHARGEPLANNINGREQUIREMENTSANDAFTER -CARESUPPORT FOR TRANSITIONINGAT MEMBERSLEAST RECEIVINGSIX QUALIFIEDMONTHS RESIDENTIALAFTER TREATMENTDISCHARGE SERVICES,INCLUDING ANDEXPECTATIONS PSYCHIATRICTHATDISCHARGEPLANNINGBEGINSATADMISSIONANDTHATALLRELEVANT RESIDENTIALPARTIESHAVEASHAREDUNDERSTANDINGOFTHE TREATMENTDISCHARGE SERVICESPLANANDOF PRIORAVAILABLE TOSTEP-DOWN JULYAND 1,COMMUNITY 2027,-BASED FROMSERVICE FEE-FOR-SERVICETOMANAGEDCAREONOPTIONS; JULY1,2027,INCLUDINGTIMING AND RESPONSIBILITY;

(i)(g) STATEWIDERECOMMENDATIONSTOADDRESSSYSTEMBARRIERSRELATEDTO REQUIREMENTSDISCHARGE FORPLANNING MANAGED,PLACEMENT CAREAVAILABILITY ENTITIES , INCLUDINGAND MINIMUMCONTINUITY EXPECTATIONSOF FORCARE PROCESSES , TIMELINES,INCLUDING APPLICATIONALIGNMENT OFBETWEEN POLICIESCLINICAL RELATEDREADINESS TOFOR AUTHORIZATIONDISCHARGE ,UTILIZATIONAND MANAGEMENTAVAILABLE ,CAREPLACEMENT COORDINATIONOR ,ANDCOMMUNITY -BASED SERVICE DELIVERY;DECISIONOPTIONS; MAKING ;

AND(h) APPLICATIONPROCESSESFORTRANSITIONINGMEMBERSRECEIVINGQUALIFIED OFRESIDENTIAL THETREATMENT EARLYSERVICES AND PERIODICPSYCHIATRIC SCREENING,RESIDENTIAL DIAGNOSTICTREATMENT ANDSERVICES TREATMENTPRIOR BENEFITTO ;JULY 1, 2027,FROM FEE-FOR-SERVICE TO MANAGED CARE ON JULY 1,2027,INCLUDING TIMING AND RESPONSIBILITY;

-5-(i) 188S (j)TATEWIDE ATAREQUIREMENTS ,REPORTING,ANDTRANSPARENCYNEEDSNECESSARYTOFOR SUPPORTMANAGED IMPLEMENTATIONCARE ,OVERSIGHT,ANDENTITIES ONGOING, EVALUATIONINCLUDING OFMINIMUM THEEXPECTATIONS TRANSITION;ANDFOR (k)PROCESSES CONSIDERATION, OFFISCALIMPACTSANDALIGNMENTTIMELINES ACROSS ENTITIES,INCLUDING POTENTIAL COST SHIFT, RATE ADEQUACY , ANDAPPLICATION FUNDING RESPONSIBILITIES ASSOCIATED WITH THE TRANSIT.ON (3) NOLATERTHAN JULY1,2027,THESTATEDEPARTMENTSHALL IMPLEMENT OR INITIATE THE TRANSITION OF SERVICESPOLICIES PROVIDEDRELATED INTO QUALIFIEDAUTHORIZATION RESIDENTIAL,UTILIZATION TREATMENTMANAGEMENT PROGRAMS,CARE ANDCOORDINATION PSYCHIATRIC, RESIDENTIALTREATMENTFACILITIESTOTHEMANAGEDCARESYSTEMFOR MEMBERS IN THE CARE AND CUSTODYSERVICE OFDELIVERY A;DECISION COUNTYMAKING DEPARTMENT; OF HUMAN OR SOCIAL SERVICES ACCORDING TO THE POLICIES AND RECOMMENDATIONS DEVELOPED PURSUANT TO SUBSECTION (2)OF THIS SECTION.

(4)AND NOAPPLICATION LATEROF THANOTHE CTOBEREARLY 1,2026,DECEMBER 31,2026, AND MPERIODIC ARCHSCREENING 1,, 2027THEDIAGNOSTIC STATE,AND DEPARTMENTTREATMENT SHALLBENEFIT SUBMIT; A QUARTERLY REPORT TO THE JOINT BUDGET COMMITTEE THAT INCLUDE:

(j) DATA ,REPORTING,AND TRANSPARENCY NEEDS NECESSARY TO SUPPORTIMPLEMENTATION ,OVERSIGHT ,ANDONGOINGEVALUATIONOFTHE TRANSITION;AND (k) CONSIDERATION OF FISCAL IMPACTS AND ALIGNMENT ACROSS ENTITIES,INCLUDING POTENTIAL COST SHIFTS , RATE ADEQUACY ,AND FUNDING RESPONSIBILITIES ASSOCIATED WITH THE TRANSITION (3) NO LATER THAN JULY 1, 2027,THE STATE DEPARTMENT SHALL IMPLEMENT OR INITIATE THE TRANSITION OF SERVICES PROVIDED IN QUALIFIED RESIDENTIAL TREATMENT PROGRAMS AND PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES TO THE MANAGED CARE SYSTEM FOR MEMBERSINTHECAREANDCUSTODYOFACOUNTYDEPARTMENTOFHUMAN PAGE 4-SENATE BILL 26-188 ORSOCIALSERVICESACCORDINGTOTHEPOLICIESANDRECOMMENDATIONS DEVELOPED PURSUANT TO SUBSECTION (2)OF THIS SECTION.

(4) N O LATER THAN OCTOBER 1, 2026, ECEMBER 31, 2026,AND M ARCH 1, 2027,THE STATE DEPARTMENT SHALL SUBMIT A QUARTERLY REPORT TO THE JOINT BUDGET COMMITTEE THAT INCLUDES :

(b) ALISTA LIST OF ATTENDEES AT EACH MEETIN;MEETING ;

(c) ASUMMARYA SUMMARY OF THE TOPICS DISCUSSED;ANDDISCUSSED ;AND (d) ASUMMARYA SUMMARY OF DECISIONS MADE TO DATE .

(5) NOLATERTHANN JULY1,2028,THESTATEDEPARTMENTSHALLO LATER THAN JULY 1, 2028,THE STATE DEPARTMENT SHALL SUBMIT A REPORT TO THE JOINT BUDGET COMMITTEE OUTLINI:GOUTLINING (a): THE OUTCOMES OF THE IMPLEMENTED POLICIE;

(b)(a) ANYTHE IDENTIFIEDOUTCOMES IMPACTSOF TOTHE PLACEMENTIMPLEMENTED STABILITY,CAREPOLICIES COORDINATION; ,AND SYSTEM ALIGNMENT ;AND -6- 188 (c) RECOMMENDATIONS FOR ANY STATUTORY OR BUDGETARY CHANGES NECESSARY TO SUPPORT ONGOING IMPLEMENTATION .

(b) A NY IDENTIFIED IMPACTS TO PLACEMENT STABILITY ,CARE COORDINATION ,AND SYSTEM ALIGNMENT ;AND (c) RECOMMENDATIONS FOR ANY STATUTORY OR BUDGETARY CHANGES NECESSARY TO SUPPORT ONGOING IMPLEMENTATION .